Well: Good and Bad, the Little Things Add Up in Fitness

Phys Ed

Gretchen Reynolds on the science of fitness.

The past year in fitness has been alternately inspiring, vexing and diverting, as my revisiting of all of the Phys Ed columns published in 2012 makes clear. Taken as a whole, the latest exercise-related science tells us that the right types and amounts of exercise will almost certainly lengthen your life, strengthen your brain, affect your waistline and even clear debris from inside your body’s cells. But too much exercise, other 2012 science intimates, might have undesirable effects on your heart, while popping painkillers, donning stilettos and sitting and reading this column likewise have their costs.

With New Year’s exercise resolutions still fresh and hopefully unbroken on this, day two of 2013, it now seems like the perfect time to review these and other lessons of the past year in fitness science.

First, since I am habitually both overscheduled and indolent, I was delighted to report, as I did in June, that the “sweet sport” for health benefits seems to come from jogging or moderately working out for only a brief period a few times a week.

Specifically, an encouraging 2012 study of 52,656 American adults found that those who ran 1 to 20 miles per week at an average pace of about 10 or 11 minutes per mile — my leisurely jogging speed, in fact — lived longer, on average, than sedentary adults. They also lived longer than the group (admittedly small) who ran more than 20 miles per week.

“These data certainly support the idea that more running is not needed to produce extra health and mortality benefits,” Dr. Carl J. Lavie, a cardiologist in New Orleans and co-author of the study told me. “If anything,” he said, “it appears that less running is associated with the best protection from mortality risk.”

Similarly, in a study from Denmark that I wrote about in September, a group of pudgy young men lost more weight after 13 weeks of exercising moderately for about 30 minutes several times a week than a separate group who worked out twice as much.

The men who exercised the most, the study authors discovered, also subsequently ate more than the moderate exercisers.

Even more striking, however, the vigorous exercisers subsequently sat around more each day than did the men who had exercised less, motion sensors worn by all of the volunteers showed.

“They were fatigued,” said Mads Rosenkilde, a Ph.D. candidate at the University of Copenhagen and the study’s co-author.

Meanwhile, the men who had worked out for only about 30 minutes seemed to be energized by their new routines. They stood up, walked, stretched and even bounced in place more than they once had. “It looks like they were taking the stairs now, not the elevators, and just moving around more,” Mr. Rosenkilde said. “It was little things, but they add up.”

And that idea was, in fact, perhaps the most dominant exercise-science theme of 2012: that little things add up, with both positive and pernicious effects. Another of my favorite studies of 2012 found that a mere 10 minutes of daily physical activity increased life spans in adults by almost two years, even if the adults remained significantly overweight.

But the inverse of that finding proved to be equally true: not fitting periods of activity into a person’s daily life also affected life span. Perhaps the most chilling sentence that I wrote all year reported that, according to a large study of Western adults, “Every single hour of television watched after the age of 25 reduces the viewer’s life expectancy by 21.8 minutes.”

I am watching much less television these days.

But not all of the new fitness science I covered this year was quite so sobering or, to be honest, consequential. Some of the more practical studies simply validated common sense, including reports that to succeed in ball sports, keep your eye on the ball; during hot-weather exercise, pour cold water over your head; and, finally, on the day before a marathon, eat a lot.

But when I think about the science that has most affected how I plan my life, I return again and again to those studies showing that physical activity alters how long and how well we live. My days of heedless youth are behind me. So I won’t soon forget the study I wrote about in September detailing how moderate, frequent physical activity in midlife can delay the onset of illness and frailty in old age. Exercise won’t prevent you from aging, of course. Only death does that. But this study and others from this year underscore that staying active, even in moderate doses, dramatically improves how your aging body feels and responds.

Aging also inspired my favorite reader comment of 2012, which was posted in response to a research scientist’s name. “‘Dr. Head,’” the reader wrote. “That shall be the name of my all-senior-citizen metal band,” which, if its members gyrate and vigorously bound about like Mick Jagger on his recent tour, should ensure themselves decades in which to robustly perform.

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Republicans Eye a Debt Fight Obama Wants to Sidestep

WASHINGTON — President Obama’s eyes narrowed late Tuesday as he looked into the cameras and warned Republicans that he had no intention of ever getting pulled into another negotiation over raising the nation’s borrowing limit.

“I will not have another debate with this Congress over whether or not they should pay the bills that they’ve already racked up through the laws that they passed,” the president said, pausing to repeat himself. “We can’t not pay bills that we’ve already incurred.”

But it is not clear exactly how Mr. Obama can avoid engaging in just such a tug of war.

In the wake of the president’s victory on taxes over the New Year’s holiday, Republicans in Congress are betting that by refusing to unconditionally raise the $16.4 trillion debt ceiling, they can force Mr. Obama to the bargaining table on spending cuts and issues like reform of Medicare and Social Security.

That would inevitably reprise the bitter clash over the debt ceiling in the summer of 2011, when the government came close to shutting down before lawmakers and the president agreed to a $1.2 trillion package of spending cuts in exchange for Republican agreement to raise the debt ceiling by about the same amount.

And that is exactly what Republicans want.

The party’s caucus in the House will discuss its debt ceiling strategy at its retreat in Williamsburg, Va., in a couple of weeks, according to a top Republican aide, who said it was determined to insist again on spending cuts that equal the increase in the amount the country can borrow.

“The speaker told the president to his face that everything you want in life comes with a price. That doesn’t change here,” the Republican aide said. “I don’t think he has any choice.”

That strategy could risk a new round of criticism aimed at Republicans from a public weary of brinkmanship. The 2011 fight ended with a last-minute deal but led to a downgrade in the rating of the nation’s debt and a slump in the economic recovery.

But Brendan Buck, a spokesman for Speaker John A. Boehner, said Republicans had made it clear what they wanted in exchange for a willingness to allow borrowing to increase.

“If they want to get the debt limit raised, they are going to have to engage and accept that reality,” Mr. Buck said. “The president knows that.”

In fact, the White House has been on notice for months that Republicans view the debt ceiling as leverage in the next budget fight. Now, the question is what Mr. Obama and his advisers can do to sidestep that fight.

One possibility is to turn to business executives for support. Many top chief executives view the possibility of a debt ceiling crisis as a significant impediment to the nation’s economy just as it is beginning to grow again. Those executives might try to pressure Republican lawmakers not to use the country’s credit as a negotiating tool.

Mr. Obama might also take to the road again, using the power of his office to try to convince the public that another fight over the debt ceiling risks another economic crisis. Public polls after the last debt ceiling fight suggested that more people blamed Republicans for the threat of a default.

The president and his aides have signaled that they will try to educate the public by explaining that the increase in the borrowing limit is necessary to cover debts that the government has already incurred. In his statement on Tuesday night, Mr. Obama warned about what would happen if the country did not meet its obligations.

“If Congress refuses to give the United States government the ability to pay these bills on time, the consequences for the entire global economy would be catastrophic — far worse than the impact of a fiscal cliff,” Mr. Obama said.

In the coming days and weeks, Mr. Obama is likely to try to focus negotiations on the other looming issue: how to avoid deep across-the-board cuts to the nation’s military and domestic programs. The deal passed on Tuesday postpones those cuts for two months, but Mr. Obama and lawmakers in both parties are eager to avoid them.

Instead, the president wants a debate over spending cuts and tax changes that would remove loopholes and deductions for wealthy Americans.

That fight is coming. The question is whether the president can avoid conducting it in the middle of a nasty, drawn-out debate over the debt limit.

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Kim Jong-un, North Korean Leader, Makes Overture to South

SEOUL, South Korea — The North Korean leader, Kim Jong-un, called for an end to the “confrontation” with rival South Korea on Tuesday in what appeared to be an overture to the incoming South Korean president as she was cobbling together South Korea’s new policy on the North.

North Korea issued a major policy statement on New Year’s Day, following a tradition set by Mr. Kim’s grandfather, the North Korean founder Kim Il-sung, and continued by his father, Kim Jong-il, who died in December 2011, bequeathing the dynastic rule to Mr. Kim.

Although Mr. Kim inherited the central policies of his father, outside analysts see him as trying to distance himself in a variety of ways from his father’s ruling style. Kim Jong-il was more feared than respected among his people, and his rule was marked by a major famine.

The most significant feature of Kim Jong-un’s speech was its marked departure of tone regarding South Korea.

“A key to ending the divide of the nation and achieving reunification is to end the situation of confrontation between the North and the South,” Mr. Kim said. “A basic precondition to improving North-South relations and advancing national reunification is to honor and implement North-South joint declarations.”

He was referring to two inter-Korean agreements, signed in 2000 and 2007, when two South Korean presidents, Kim Dae-jung and Roh Moo-hyun, were pursuing a “Sunshine Policy” of reconciliation and economic cooperation with North Korea and met Mr. Kim’s father in the North Korean capital, Pyongyang.

As a result of those agreements, billions of dollars of South Korean investment, aid and trade flowed into the North. Billions more were promised in investments in shipyards and factory parks, as the South Korean leaders believed that economic good will was the best way of encouraging North Korea to shed its isolation and hostility while reducing the economic gap between the Koreas and the cost of reunification in the future.

But that warming of ties ended when conservatives came to power in South Korea with the inauguration of President Lee Myung-bak in 2008. Mr. Lee suspended any large aid or investment because of the lack of progress toward dismantling the North’s nuclear weapons programs, and inter-Korean relations spiraled down, further aggravated by the North’s shelling of a South Korean island in 2010.Mr. Kim’s speech on Tuesday, which was broadcast through the North’s state-run television and radio stations, was another sign that the young leader was trying to emulate his grandfather, who was considered a more people-friendly leader and is still widely revered among North Koreans.

Mr. Kim returned to the tradition of Kim Il-sung, issuing the statement in a personal speech. During the rule of Kim Jong-il, the statement — which laid out policy guidelines for the new year and was studied by all branches of the party, state and military — was issued as a joint editorial of the country’s main official media.

In his speech, Kim Jong-un, echoed themes of previous New Year’s messages, emphasizing that improving the living standards of North Koreans and rejuvenating the agricultural and light industries were among the country’s main priorities.

But he revealed no details of any planned economic policy changes. He mentioned only a need to “improve economic leadership and management” and “spread useful experiences created in various work units.”

Since July, reports from various media suggest that Mr. Kim’s government has begun carrying out cautious economic incentives aimed at bolstering productivity at farms and factories. Some reports said the state was considering letting farmers keep at least 30 percent of their yield; currently, it is believed, they are allowed to sell only a surplus beyond a government-set quota that is rarely met.

Mr. Kim also vowed to strengthen his country’s military, calling for the development of more advanced weapons. But he made no mention of relations with the United States or the international efforts to halt North Korea’s nuclear weapons program. He simply reiterated that his government was willing to “expand and improve upon friendly and cooperative relationships with all countries friendly to us.”

Mr. Kim’s speech followed the successful launching of a satellite aboard a long-range rocket in December. North Korea’s propagandists have since been busy billing the launch as a symbol of what they called the North’s soaring technological might and Mr. Kim’s peerless leadership. Washington considered it a test of long-range ballistic-missile technology and a violation of United Nations Security Council resolutions banning such tests, and is seeking more sanctions to impose on the isolated country.

The incoming leader of South Korea, Park Geun-hye, who was the presidential candidate of Mr. Lee’s conservative governing party, did not immediate respond to the speech. Ms. Park is the daughter of Park Chung-hee, the former military strongman under whose rule from 1961 until 1979 a staunchly anti-Communist, pro-American political establishment took root in South Korea.

North Korea had engineered a couple of assassination attempts on Ms. Park’s father, one of which resulted in her mother’s death in 1974. But Ms. Park also traveled to Pyongyang in 2002 and discussed inter-Korean reconciliation with Kim Jong-il.

During her campaign for president, she said that if elected, she would decouple humanitarian aid from politics and try to hold a summit meeting with Kim Jong-un. She was in part reacting to widespread criticism in South Korea that Mr. Lee’s hard-line policy did little to change the North’s behavior.

During the campaign, however, Ms. Park stuck to Mr. Lee’s stance on the most contentious issue of large-scale investment, which the North considers crucial. Ms. Park, like the current president, insisted that any large-scale economic investments be preceded by the “building of trust” through progress in curbing North Korea’s nuclear weapons program.

Peace bought with “shoveling” of unrestrained aid under the Sunshine Policy was “a fake,” she said, citing the North’s long history of using military threats to win economic concessions.

Earlier, North Korea called her a “confrontational maniac” and “fascist.” But since her election, it has refrained from attacking her.

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9 Apps to Fast-Track Your New Years’ Resolutions

Whether your goal in 2013 is to lose five pounds, manage your finances, or spend more time with friends and family, there are a growing number of apps that fall into the self-help category and can assist you in accomplishing these resolutions.

At Mashable we’ve tested a lot of them out, but we’re still always hearing about new ones. There are a ton of fitness and health apps to chose from, but you might be pleasantly surprised to know they’re not all about weight loss. A device and app called Tinke monitors your stress levels and how deeply you’re breathing. An app called Fig will remind you to drink more water, skip fried foods and take breaks at work to keep you feeling good. Arianna Huffington also released an app called, “GPS for the Soul” that focuses on wellbeing.

[More from Mashable: Time Machine App Transports You Back to 2012]

Other apps can help you organize your social life, make new friends or save money for a vacation.

We’ve compiled a list of apps that can help you accomplish all sorts of goals this year. Check it out and let us know if we missed any that you plan on using in 2013.

[More from Mashable: It’s Easy to Save Videos From Facebook Poke Permanently]

OurGroceries

If you’re trying to eat out less and cook at home more often, make sure you always have a current grocery list at your fingertips. Mashable wrote about several grocery list apps this year. The standout seems to be OurGroceries for Android and iOS. If you have roommates or a significant other, everyone can download the app and sync lists. That way if you’re making a quick after-work trip to the grocery store you’ll not only be able to see the items you added, but also see what they’ve added, too.

Click here to view this gallery.

Photo courtesy of iStockphoto, hocus-focus

This story originally published on Mashable here.

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Governor to sue NCAA over Penn State sanctions

HARRISBURG, Pa. (AP) — Gov. Tom Corbett said Tuesday he plans to sue the NCAA in federal court over stiff sanctions imposed against Penn State University in the wake of the Jerry Sandusky child sexual abuse scandal.

The Republican governor scheduled a Wednesday news conference on the Penn State campus in State College to announce the antitrust filing in U.S. District Court in Harrisburg.

The sanctions, which were agreed to by the university in July, included a $60 million fine that would be used nationally to finance child abuse prevention grants. The sanctions also included a four-year bowl game ban for the university's marquee football program, reduced football scholarships and the forfeiture of 112 wins but didn't include a suspension of the football program, the so-called death penalty.

The governor's office announced the news conference late Tuesday afternoon. His spokesman did not respond to repeated calls and emails seeking to confirm a Sports Illustrated story that cited anonymous sources saying a lawsuit was imminent.

Corbett's brief statement did not indicate whether his office coordinated its legal strategy with state Attorney General-elect Kathleen Kane, who is scheduled to be sworn in Jan. 15.

Kane, a Democrat, ran on a vow to investigate why it took state prosecutors nearly three years to charge Sandusky, an assistant under former football coach Joe Paterno. Corbett was the attorney general when that office took over the case in early 2009 and until he became governor in January 2011.

State and congressional lawmakers from Pennsylvania have objected to using the Penn State fine to finance activities in other states. Penn State has already made the first $12 million payment, and an NCAA task force is deciding how it should be spent.

The NCAA, which did not respond to calls seeking comment Tuesday, has said at least a quarter of the money would be spent in Pennsylvania.

Republican U.S. Rep. Charlie Dent called that an "unacceptable and unsatisfactory" response by the NCAA to a request from the state's U.S. House delegation that the whole $60 million be distributed to causes within the state.

Last week, state Sen. Jake Corman, a Republican whose district includes Penn State's main campus, said he plans to seek court action barring any of the first $12 million from being released to groups outside the state.

Sandusky, 68, was convicted in June on charges he sexually abused 10 boys, some on Penn State's campus. He's serving a 30- to 60-year state prison term.

Eight young men testified against him, describing a range of abuse they said went from grooming and manipulation to fondling, oral sex and anal rape when they were boys.

Sandusky did not testify at his trial but has maintained his innocence, acknowledging he showered with boys but insisting he never molested them.

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Study Suggests Lower Mortality Risk for Overweight People

A century ago, Elsie Scheel was the perfect woman. So said a 1912 article in The New York Times about how Miss Scheel, 24, was chosen by the “medical examiner of the 400 ‘co-eds’ ” at Cornell University as a woman “whose very presence bespeaks perfect health.”

Miss Scheel, however, was hardly model-thin. At 5-foot-7 and 171 pounds, she would, by today’s medical standards, be clearly overweight. (Her body mass index was 27; 25 to 29.9 is overweight.)

But a new report suggests that Miss Scheel may have been onto something. The report on nearly three million people found that those whose B.M.I. ranked them as overweight had less risk of dying than people of normal weight. And while obese people had a greater mortality risk over all, those at the lowest obesity level (B.M.I. of 30 to 34.9) were not more likely to die than normal-weight people.

The report, although not the first to suggest this relationship between B.M.I. and mortality, is by far the largest and most carefully done, analyzing nearly 100 studies, experts said.

But don’t scrap those New Year’s weight-loss resolutions and start gorging on fried Belgian waffles or triple cheeseburgers.

Experts not involved in the research said it suggested that overweight people need not panic unless they have other indicators of poor health and that depending on where fat is in the body, it might be protective or even nutritional for older or sicker people. But over all, piling on pounds and becoming more than slightly obese remains dangerous.

“We wouldn’t want people to think, ‘Well, I can take a pass and gain more weight,’ ” said Dr. George Blackburn, associate director of Harvard Medical School’s nutrition division.

Rather, he and others said, the report, in The Journal of the American Medical Association, suggests that B.M.I., a ratio of height to weight, should not be the only indicator of healthy weight.

“Body mass index is an imperfect measure of the risk of mortality,” and factors like blood pressure, cholesterol and blood sugar must be considered, said Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis.

Dr. Steven Heymsfield, executive director of the Pennington Biomedical Research Center in Louisiana, who wrote an editorial accompanying the study, said that for overweight people, if indicators like cholesterol “are in the abnormal range, then that weight is affecting you,” but that if indicators are normal, there’s no reason to “go on a crash diet.”

Experts also said the data suggested that the definition of “normal” B.M.I., 18.5 to 24.9, should be revised, excluding its lowest weights, which might be too thin.

The study did show that the two highest obesity categories (B.M.I. of 35 and up) are at high risk. “Once you have higher obesity, the fat’s in the fire,” Dr. Blackburn said.

But experts also suggested that concepts of fat be refined.

“Fat per se is not as bad as we thought,” said Dr. Kamyar Kalantar-Zadeh, professor of medicine and public health at the University of California, Irvine.

“What is bad is a type of fat that is inside your belly,” he said. “Non-belly fat, underneath your skin in your thigh and your butt area — these are not necessarily bad.”

He added that, to a point, extra fat is accompanied by extra muscle, which can be healthy.

Still, it is possible that overweight or somewhat obese people are less likely to die because they, or their doctors, have identified other conditions associated with weight gain, like high cholesterol or diabetes.

“You’re more likely to be in your doctor’s office and more likely to be treated,” said Dr. Robert Eckel, a past president of the American Heart Association and a professor at University of Colorado.

Some experts said fat could be protective in some cases, although that is unproven and debated. The study did find that people 65 and over had no greater mortality risk even at high obesity.

“There’s something about extra body fat when you’re older that is providing some reserve,” Dr. Eckel said.

And studies on specific illnesses, like heart and kidney disease, have found an “obesity paradox,” that heavier patients are less likely to die.

Still, death is not everything. Even if “being overweight doesn’t increase your risk of dying,” Dr. Klein said, it “does increase your risk of having diabetes” or other conditions.

Ultimately, said the study’s lead author, Katherine Flegal, a senior scientist at the Centers for Disease Control and Prevention, “the best weight might depend on the situation you’re in.”

Take the perfect woman, Elsie Scheel, in whose “physical makeup there is not a single defect,” the Times article said.

This woman who “has never been ill and doesn’t know what fear is” loved sports and didn’t consume candy, coffee or tea. But she also ate only three meals every two days, and loved beefsteak.

Maybe such seeming contradictions made sense against the societal inconsistencies of that time. After all, her post-college plans involved tilling her father’s farm, but “if she were a man, she would study mechanical engineering.”

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Shell Oil Rig Runs Aground in Alaska

An enormous Shell Oil offshore drilling rig ran aground on an island in the Gulf of Alaska on Monday night after it broke free from tow ships in rough seas, officials said.

The rig, the Kulluk, which was used for test drilling in the Arctic last summer, is carrying about 139,000 gallons of diesel fuel and 12,000 gallons of lubricating oil and hydraulic fluid, the officials said.

A Coast Guard helicopter flew over the rig after the grounding at 8:48 p.m. and “detected no visible sheen,” said Darci Sinclair, a spokeswoman for a unified command of officials from Shell, Alaskan state agencies and other groups that has been directing the response since the troubles with the rig began last Thursday.

Ms. Sinclair said that more overflights were planned after daybreak on Tuesday, and that the unified command would be monitoring the fuel situation as it planned further actions. “The focus will be around salvage,” she said.

The 266-foot diameter rig ran aground on the east coast of Sitkalidak Island, an uninhabited island that is separated by the Sitkalidak Strait from the far larger Kodiak Island to the west. The nearest town, Old Harbor, is across the strait on Kodiak Island; it has a population of about 200 people.

Ms. Sinclair said the coast where the Kulluk ran aground has a combination of rocky and sandy terrain.

Earlier Monday, a Shell spokesman had said that the rig had been brought under control after towlines were reconnected to two ships during a break in what had been several days of extremely rough seas and high winds.

But late Monday afternoon the line from one of the ships, the Aiviq, became separated. Then several hours later, the other ship, the Alert, was ordered to disconnect its towline, out of concern for the safety of the ship’s nine-person crew. At the time, Ms. Sinclair said, swells were as high as 35 feet and winds were gusting up to 65 miles an hour.

The Kulluk, one of two rigs that Shell used to drill test wells off the North Slope of Alaska as part of the company’s ambitious and expensive effort to open Arctic waters to oil production, was being towed by the Aiviq to a Seattle shipyard for off-season maintenance when the towline initially separated during a storm on Thursday.

The Aiviq then lost power, and other support ships and a Coast Guard cutter were brought in to help with engine repairs and to reconnect towlines to the Kulluk, which does not have its own propulsion system. The 18 workers aboard the rig were evacuated by Coast Guard helicopters on Saturday.

Over the weekend, support crews struggled in 25-foot swells to reconnect towlines, succeeding several times. But each time the lines separated again, leaving the rig in danger of drifting toward land.

The Kulluk, which was built in Japan in 1983 and upgraded over the past six years at a cost of $292 million, is designed for icy conditions in the Arctic. It can drill in up to 400 feet of water and up to 20,000 feet deep. During drilling season it carries a crew of about 140 people, Mr. Smith said.

Shell has spent six years and more than $4 billion in its effort to drill in Arctic waters, one of the last untapped oil-producing regions in the United States. But the effort has faced regulatory hurdles and opposition from American Indian and environmental groups.

Last summer, the Kulluk drilled a shallow test well in the Beaufort Sea while another rig drilled a similar hole in the Chukchi Sea to the west.

But Shell announced in September that it would be forced to delay further drilling until this year after a specialized piece of equipment designed to contain oil from a spill was damaged in a testing accident.

The episode was one of a number of setbacks for the Arctic drilling program last year.

Shell now says it hopes to drill five exploratory wells in the region during the 2013 drilling season, which begins in mid-July.

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12 Foreign Stories From 2012 Worth Revisiting

Tyler Hicks/The New York Times

There were hundreds of memorable foreign stories from Times correspondents in 2012. Here is a sampling of 12 from across the world in reverse chronological order

1. For Congo Children, Food Today Means None Tomorrow

KINSHASA, Democratic Republic of Congo — Today, the big children will eat, Cynthia, 15, and Guellor, 13. Tomorrow, it will be the turn of the little ones, Bénédicte, Josiane and Manassé, 3, 6, and 9.

2. Dublin Journal: Not Worth the Paper It’s Built On

DUBLIN — As an emblem of the modern Irish condition, Frank Buckley is almost too apt. Dead broke, he lives in a house made of money.

3. American Children, Now Struggling to Adjust to Life in Mexico

Shaul Schwarz for The New York Times

IZÚCAR DE MATAMOROS, Mexico — Jeffrey Isidoro sat near the door of his fifth-grade classroom here in central Mexico, staring outside through designer glasses that, like his Nike sneakers and Nike backpack, signaled a life lived almost entirely in the United States. His parents are at home in Mexico. Jeffrey is lost.

4. Egypt’s Everywoman Finds Her Place Is in the Presidential Palace

CAIRO — Naglaa Ali Mahmoud wears an Islamic head covering that drapes down to her knees, did not attend college and never took her husband’s last name, because that is a Western convention that few Egyptians follow. She also refuses the title of first lady, in favor of simply Um Ahmed, a traditional nickname that identifies her as the mother of Ahmed, her eldest son.

5. A Superstar Televangelist in Pakistan Divides, Then Repents

Diego Ibarra Sanchez for The New York Times

KARACHI, Pakistan — THE audience erupted as Aamir Liaquat Hussain, Pakistan’s premier televangelist, darted around the television studio, firing off questions about Islam. “How many gates are there to heaven?” he challenged.

6. Elephants Dying in Epic Frenzy as Ivory Fuels Wars and Profits

GARAMBA NATIONAL PARK, Democratic Republic of Congo — In 30 years of fighting poachers, Paul Onyango had never seen anything like this. Twenty-two dead elephants, including several very young ones, clumped together on the open savanna, many killed by a single bullet to the top of the head.

7. Young Lives, Lost in the Fog of War

KABUL, Afghanistan — These days, Abdul Farhad tries to sleep with the lights on in his bedroom and his eyes wide open, because as soon as he closes them he is back in his shop in central Kabul and it is 11:30 a.m. on the eighth of September.

8. Corruption Is Seen as a Drain on Italy’s South

Gianni Cipriano for The New York Times

REGGIO CALABRIA, Italy — Italy’s A3 highway, begun in the 1960s and still not finished, starts outside Naples in the ancient hill town of Salerno and ends, rather unceremoniously, 300 miles farther south as a local street in downtown Reggio Calabria.

9. Reporting a Fearful Rift Between Afghans and Americans

SISAY OUTPOST, Afghanistan — How far is Kabul from the war? These days, if you drive south or west, no more than an hour and a half. You can go and be back for dinner — if you aren’t kidnapped or blown up.

10. Billions in Hidden Riches for Family of Chinese Leader

BEIJING — The mother of China’s prime minister was a schoolteacher in northern China. His father was ordered to tend pigs in one of Mao’s political campaigns. And during childhood, “my family was extremely poor,” the prime minister, Wen Jiabao, said in a speech.

11. Long Retired, Ex-Leader of China Asserts Sway Over Top Posts

BEIJING — In a year of scandals and corruption charges at the commanding heights of the Communist Party, a retired party chief some had written off as a spent force has thrust himself back into China’s most important political decisions and emerged as a dominant figure shaping the future leadership.

12. Horrific Fire Revealed a Gap in Safety for Global Brands

ASHULIA, Bangladesh — The fire alarm shattered the monotony of the Tazreen Fashions factory. Hundreds of seamstresses looked up from their machines, startled. On the third floor, Shima Akhter Pakhi had been stitching hoods onto fleece jackets. Now she ran to a staircase.

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Redskins win NFC East, Broncos get top seed in AFC

RG3 and the Washington Redskins are heading to the playoffs as NFC East champions.

By winning their seventh straight game, the Redskins rolled to their first division title in 13 years with a 28-18 victory over the Dallas Cowboys on Sunday night. Next up for Robert Griffin III & Co.: a home playoff matchup next Sunday with the Seahawks — the third straight postseason game for Washington against Seattle.

"It's just a mindset change," the rookie quarterback said. "When you have all these guys coming to work every day, putting it on the line, we knew we couldn't afford to lose one game, we made sure we didn't"

Thanks to Houston's late-season slump, Denver and New England will have byes when the AFC playoffs begin next week.

The Texans fell from first to third in the conference Sunday when they lost 28-16 at Indianapolis, which welcomed back coach Chuck Pagano after nearly three months of treatments for leukemia.

AFC West champion Denver won its 11th straight game, 38-3 over Kansas City to secure the top seed. New England blanked Miami 28-0 for the second spot.

Minnesota edged Green Bay 37-34 to grab the final NFC wild card, sinking the Packers to the third seed. Those teams will meet again next Saturday night at Lambeau Field.

The other NFC matchup will have Seattle (11-5), which beat St. Louis 20-13, at Washington on Sunday at 4:30 p.m. ET.

Cincinnati (10-6) will be at Houston on Saturday at 4:30 p.m. ET, and Indianapolis (11-5) goes to at Baltimore (10-6) on Sunday at 1 p.m. in the AFC wild-card rounds.

The divisional round games will be hosted by Denver on Saturday, Jan. 12, followed by San Francisco (11-4-1) at night. On Sunday, Jan. 13, Atlanta (13-3) will host the early game, followed by New England (12-4).

Peyton Manning threw for three touchdowns as Denver (13-3) routed the Chiefs. New England got the second seed despite having the same record as Houston because it beat the Texans, who lost three of their final four games.

Adrian Peterson had 199 yards against the Packers, finishing with 2,097 — Dickerson's single-season rushing mark in 2,105. But it was rookie kicker Blair Walsh who won it with a 29-yard field goal as time expired.

"Ultimately we got the 'W,'" Peterson said. "I told myself to come into this game focused on one thing, and that's winning."

Green Bay would have been seeded second in the NFC by beating Minnesota.

"The road got a little tougher having to play on opening weekend, but we've got a home game and that's why you win the division," Aaron Rodgers said. "We get to go back home, and the game will be different. They won't have home-crowd advantage, and hopefully that will make a difference."

Baltimore Pro Bowl safety Ed Reed is looking forward to a reunion with Pagano. He wishes it would come a little later in the postseason.

"Chuck's like a dad to me," Reed said "He means a lot to me. I would have much rather seen them in the AFC championship game than the first game."

But Reed will see him next week at Baltimore.

The Ravens had a chance to move up to the AFC's third seed with a win and a New England loss. But Baltimore lost at Cincinnati as both teams played backups for much of the game.

Pagano coached the Ravens' secondary for three seasons and was promoted to coordinator last year. Players and coaches in Baltimore have kept in touch, offering encouragement as he fought through the cancer treatments.

"Going back to Baltimore, obviously there's some familiarity there," Pagano said. "We had four great years there as a family. It's a top-notch organization, you know, really good football club. It's a great challenge and they have a great team and they have great players all over the place."

The Colts were 2-14 last season and chose quarterback Andrew Luck with the top selection in the draft. Luck and offensive coordinator Bruce Arians, who stepped in as interim coach with Pagano sidelined, led the turnaround.

Next week, Pagano goes up against former boss John Harbaugh.

"I love his family, and he's one of my closest personal friends in coaching," Harbaugh said. "What he's been through is phenomenal, but we're all competitors so that gets set aside."

Houston beat Cincinnati in the opening round of last year's playoffs.

"I think it will be good," said Bengals QB Andy Dalton, who grew up in suburban Houston. "We played there last year and know the atmosphere and what it's going to be like. The experience last year will definitely help us."

The defending Super Bowl champion Giants are out of contention. When Chicago beat Detroit 26-24, the Giants (9-7) were eliminated, even though they routed Philadelphia 42-7.

"It hurts," said Eli Manning. "Each year you want to make the playoffs to give yourself an opportunity to win a championship; 9-7 last year was good enough. It wasn't good enough this year and we knew it wouldn't be."

Minnesota's win eliminated Chicago.

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F.D.A. Approves Sirturo, a New Tuberculosis Drug

The Food and Drug Administration announced on Monday that it had approved a new treatment for multidrug-resistant tuberculosis that can be used as an alternative when other drugs fail.

The drug, to be called Sirturo, was discovered by scientists at Janssen, the pharmaceuticals unit of Johnson & Johnson, and is the first in a new class of drugs that aims to treat the drug-resistant strain of the disease.

Tuberculosis is a highly infectious disease that is transmitted through the air and usually affects the lungs but can also affect other parts of the body, including the brain and kidneys. It is considered one of the world’s most serious public health threats. Although rare in the United States, multidrug-resistant tuberculosis is a growing problem elsewhere in the world, especially in poorer countries. About 12 million people worldwide had tuberculosis in 2011, according to Johnson & Johnson, and about 630,000 had multidrug-resistant TB.

A study in September in The Lancet found that almost 44 percent of patients with tuberculosis in countries like Russia, Peru and Thailand showed resistance to at least one second-line drug, or a medicine used after another drug had already failed.

Treating drug-resistant tuberculosis can take years and can cost 200 times as much as treating the ordinary form of the disease

“This is quite a milestone in the story of therapy for TB,” Dr. Paul Stoffels, the chief scientific officer at Johnson & Johnson, said in an interview. He said the approval was the first time in 40 years that the agency had approved a drug that attacked tuberculosis in a different way from the current treatments on the market. Sirturo works by inhibiting an enzyme needed by the tuberculosis bacteria to replicate and spread throughout the body.

Sirturo, also known as bedaquiline, would be used on top of the standard treatment, which is a combination of several drugs. Patients with drug-resistant tuberculosis often must be treated for 18 to 24 months.

Even as it announced the approval, however, the F.D.A. also issued some words of caution.

“Multidrug-resistant tuberculosis poses a serious health threat throughout the world, and Sirturo provides much-needed treatment for patients who have don’t have other therapeutic options available,” Edward Cox, director of the office of antimicrobial products in the F.D.A.’s center for drug evaluation and research, said in a statement. “However, because the drug also carries some significant risks, doctors should make sure they use it appropriately and only in patients who don’t have other treatment options.”

The consumer advocacy group Public Citizen opposed approval in a letter to the F.D.A. in mid-December, saying that the results of a limited clinical trial showed that patients using bedaquiline were five times as likely to die than those on the standard drug regimen to treat the disease.

“Given that bedaquiline belongs to an entirely new class of drugs, it is entirely feasible that death in some cases was due to some unmeasured toxicity of the drug,” the letter said.

Sirturo carries a so-called black box warning for patients and health care professionals that the drug can affect the heart’s electrical activity, which could lead to an abnormal and potentially fatal heart rhythm. The warning also notes deaths in patients treated with Sirturo. Nine patients who received Sirturo died compared with two patients who received a placebo. Five of the deaths in the Sirturo group and all of the deaths in the placebo arm seemed to be related to tuberculosis, but no consistent reason for the deaths in the remaining Sirturo-treated patients could be identified.

Doctors Without Borders and the Bill and Melinda Gates Foundation, both active in the fight against tuberculosis and other global diseases, applauded the F.D.A.’s decision.

Jan Gheuens, interim director of the TB Program for the Gates Foundation, called it a “long-awaited event” and said the fight against TB had not benefited from new drugs in the way H.I.V. had. Beyond the benefits of the drug itself, he said the quick approval process could be a model for other drugs sorely needed in the developing world.

He also suggested, however, that more trials should be conducted to get a better understanding of the side effects that led to the black box warning.

The F.D.A. approved bedaquiline under an accelerated program that allows the agency to conditionally approve drugs that are viewed as filling unmet medical needs with less than the usual evidence that they work. The drug’s approval was based on studies that showed it killed bacteria more quickly than a control group taking the standard regimen, but it did not measure whether in the end patients actually fared better on bedaquiline. Johnson & Johnson will conduct larger clinical trials to investigate whether the drug performs as predicted.

In a statement responding to Public Citizen’s letter, a spokeswoman for Johnson & Johnson said the company was committed to supporting appropriate use of Sirturo and would “work to ensure Sirturo is used only where treatment alternatives are not available.”

Dr. Stoffels said the hope was that other new tuberculosis drugs would also be approved that, when used in combination with bedaquiline, could shorten and simplify the current standard of treatment. “That is still a long time away,” he acknowledged, but “this is a first step in a new regimen for TB.”

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